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Comparison of Single Agent Gemcitabine and Docetaxel in Second-Line Therapy for Advanced Stage Non-Small Cell Lung Cancer in a University Hospital in Turkey

  • Yildirim, Fatma;Baha, Ayse;Yurdakul, Ahmet Selim;Ozturk, Can
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7859-7863
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    • 2015
  • Purpose: To compare the efficacy and toxicity of gemcitabine versus docetaxel in a second-line setting of nonsmall cell lung cancer (NSCLC) patients previously treated with platin-based combination chemotherapy. Materials and Methods: We retrospectively evaluated the medical records of 57 patients treated with single agent gemcitabine or docetaxel in second-line setting of advanced NSCLC who received one prior platinum-based therapy. Results: The mean age was $56.7{\pm}8.39$ years with 55 (96.5%) males and two (3.5%) females. Forty of them received docetaxel and 17 gemcitabine. The mean number of chemotherapy cycles was $6.8{\pm}4.0$ in the gemcitabine group, while it was $4.6{\pm}3.0$ in the docetaxel group. Overall response rates were 8% and 12% (P=0.02) for gemcitabine and docetaxel, respectively. The median survival time was 22 versus 21 months for gemcitabine and docetaxel, respectively. The median times to progression were 8 and 5 months. There was no difference between the two groups in terms of incidence of adverse affects (40% vs 47.1%). All of the hematological side effects were grade 1/2. No major toxicity was encountered necessitating stopping the drug for either group. Conclusions: Treatment with gemcitabine demonstrated clinically equivalent efficacy with a significantly improved safety profile compared with those receiving docetaxel in the second-line setting for advanced NSCLC in this study. Based on these results, treatment with gemcitabine should be considered a standard treatment option for second-line NSCLC.

Exploratory Investigation of Genetic Associations with Basal Cell Carcinoma Risk: Genome-Wide Association Study in Jeju Island, Korea

  • Yun, Byung Min;Song, Jung-Kook;Lee, Ji-Young
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7443-7447
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    • 2014
  • Aim: Little is known about the genetic associations with Basal cell carcinoma (BCC) risk in non-Caucasian populations, in which BCC is rare, as in Korea. We here conducted a pilot genome-wide association study (GWAS) in 12 patients and 48 standard controls. Method: A total of 263,511 SNPs were analyzed with the Illumina HumanOmni1 Quad v1.0 DNA Analysis BeadChip for cases and Korean HapMap 570K for controls. Results: SNP-based analyses, based on the allele genetic model with adjustment for sex and age showed suggestive associations with BCC risk for 6 SNPs with a P-value (P < 0.0005). However, these associations were not statistically significant after Bonferroni correction: rs1040503, rs2216491, rs13407683, rs4751072, rs9891263, and rs1368474. In addition, results from gene-based analyses showed suggestive associations with BCC risk for 33 candidate genes with a P-value (P <0.0005). Consistent with previous GWAS and replication studies in Caucasian populations, PADI6, RHOU and SLC45A2 were identified as having null associations with BCC (P > 0.05), likely due to the smaller sample size. Conclusions: Although this was a small-scale negative study, to our knowledge, we have conducted the first GWAS for BCC risk in an Asian population. Further large studies in non-Caucasian populations are required to achieve statistical significance and confirm these findings.

Impact of Inadequate Doses of Rituximab in the Treatment of Diffuse Large B Cell Lymphoma in Malaysian Patients

  • Gan, Gin Gin;Subramaniam, Rajaletchumy;Bee, Ping Chong;Chin, Edmund Fui Min;Abdul-Halim, Habibah;Tai, Mei Chee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1703-1706
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    • 2014
  • Background: The current standard treatment for patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) is rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP). A significant number of patients were not treated with recommended dose of rituximab due to limited financial resources in Malaysia. This study evaluates the efficacy of R-CHOP like chemotherapy in Malaysian patients with DLBCL. Materials and Methods: The study comprised a retrospective analysis of patients with DLBCL treated at a single centre. The outcome was compared with patients who were treated with R-CHOP like and CHOP like chemotherapy. Patients who were treated with lower dose of rituximab was subanalysed for outcome. Results: A total of 86 patients who had CHOP-like chemotherapy were included. Only 39 (45%) patients had rituximab and only 12 (29%) patients had the recommended dose. The overall response (OR) and complete response (CR) rates were 88% and 81% respectively. There was no significant difference in OR and CR in patients who had rituximab and those without rituxmab. Those with International Prognostic Index (IPI) score of ${\leq}2$ had significant higher CR rate, progression free survival (PFS) and overall survival (p<0.001). Conclusions: The lack of significant improvement in CR and DFS in our patients may be due to an inadequate dose of rituximab.

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

  • Bayman, Evrim;Etiz, Durmus;Akcay, Melek;Ak, Guntulu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6263-6267
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    • 2014
  • Background: It is standard treatment to combine chemotherapy (CT) and thoracic radiotherapy (TRT) in treating patients with limited stage small cell lung cancer (LS-SCLC). However, optimal timing of TRT is unclear. We here evaluated the survival impact of early versus late TRT in patients with LS-SCLC. Materials and Methods: Follow-up was retrospectively analyzed for seventy consecutive LS-SCLC patients who had successfully completed chemo-TRT between January 2006 and January 2012. Patients received TRT after either 1 to 2 cycles of CT (early TRT) or after 3 to 6 cycles of CT (late TRT). Survival and response rates were evaluated using the Kaplan-Meier method and comparisons were made using the multivariate Cox regression test. Results: Median follow-up was 24 (5 to 57) months. Carboplatin+etoposide was the most frequent induction CT (59%). Median overall, disease free, and metastasis free survivals in all patients were 15 (5 to 57), 5 (0 to 48) and 11 (3 to 57) months respectively. Late TRT was superior to early TRT group in terms of response rate (p=0.05). 3 year overall survival (OS) rates in late versus early TRT groups were 31% versus 17%, respectively (p=0.03). Early TRT (p=0.03), and incomplete response to TRT (p=0.004) were negative predictors of OS. Significant positive prognostic factors for distant metastasis free survival were late TRT (p=0.03), and use of PCI (p=0.01). Use of carboplatin versus cisplatin for induction CT had no significant impact on OS (p=0.634), DFS (p=0.727), and MFS (p=0.309). Conclusions: Late TRT appeared to be superior to early TRT in LS-SCLC treatment in terms of complete response, OS and DMFS. Carboplatin or cisplatin can be combined with etoposide in the induction CT owing to similar survival outcomes.

The Relationships among Social Support, Hope, Anxiety, and Depression in Patients Expecting to Receive Hematopoietic Stem Cell Transplantation (조혈모세포 이식 전 환자의 사회적 지지, 희망, 불안 및 우울의 관계)

  • Bae, Ka Ryeong;Kim, Sue
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.30-42
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    • 2016
  • Purpose: This study aimed to examine the relationships among social support(family support, medical team support), hope, anxiety, and depression in patients with hematologic cancers before they received hematopoietic stem cell transplantation (HSCT) to obtain baseline data for developing a nursing intervention. Methods: The participants were 70 adult patients expecting to receive HSCT from 5 university hospitals in Seoul, Gyeonggi-do, and Jeollanam-do regions. A cross-sectional survey was done using standardized instruments for social support (Tae's Family Support Scale and Professional Medical Support Scale), hope (Kim & Lee Hope Scale), anxiety and depression (Hospital Anxiety and Depression Scale). The data were analyzed by SPSS/WIN 19.0 program using frequency, percentage, item mean and standard deviation, t-test, ANOVA, and Pearson's correlation coefficient. Results: Hope was significantly correlated with social support (r=.40, p=.001), anxiety (r=-.40, p<.001) and depression (r=-.58, p<.001). Anxiety was correlated with depression (r=.54, p<.001). Conclusion: The findings of this study show greater social support for patients who expect to receive HSCT is significantly correlated to a higher level of hope, as well as low levels of anxiety and depression. In nursing practice, clinical nurses may develop a nursing intervention to reinforce social support and hope, as well as reduce anxiety and depression for patients preparing for HSCT.

mRNA Expression and Clinical Significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 in Postoperative Patients with Non-Small Cell Lung Cancer

  • Han, Yi;Wang, Xiao-Bin;Xiao, Ning;Liu, Zhi-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2987-2990
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    • 2013
  • Background: To explore mRNA expression and clinical significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in tumor tissue of postoperative patients with non-small cell lung cancer (NSCLC). Materials and Methods: Sixty NSCLC patients undergoing radical operation in our hospital from Nov., 2011 to Jun., 2012 were selected. Plasmid standards of ERCC1, BRCA1, RRM1, TYMS and TUBB3 were established and standard curves were prepared by SYBR fluorescent real-time quantitative PCR analysis. Samples from tumor centers were taken to detect mRNA expression of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in cancerous tissue during operation. The total mRNA expression quantities were compared according to different clinical characteristics. Results: The total expression quantities of 5 genotypes from high to low were ERCC1>RRM1>TUBB3>TYMS>BRCA1 in turn. By pairwise comparisons, other differences showed statistical significance (p<0.05 or p<0.01) except for TYMS and TUBB3 (p>0.05); the low expression rates from high to low were ERCC1>TYMS>TUBB3>TUBB3>RRM1>BRCA1 in turn. The expression quantities of BRCA1, RRM1 and TYMS in males, smokers and patients without adenocarcinoma were all significantly higher than that in females, non-smokers and patients with adenocarcinoma, and significant differences were present (p<0.05 or p<0.01). In terms of pathological staging, the expression quantities of BRCA1, RRM1 and TYMS in phases IIa~IIb and IIIa~IIIb had a tendency to be greater than in phases I and IV. Conclusions: Resistance to chemotherapy and sensitivity to targeted therapy differ among patients with NSCLC. Differences in gene expression in different individuals were also revealed. Only according to personalized detection results can individualized therapeutic regimens be worked out, which is a new direction for oncotherapy.

Optimal Timing of Radiotherapy with Alternating/Sequential Radio-Chemotherapy for Limited-stage Small Cell Lung Cancer

  • Wang, Li-Jie;Liu, Xiu-Ju;Guan, Yan;Zhang, Chu-Feng;Wang, Peng;Li, Yan;Guo, Qi-Sen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5697-5699
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    • 2014
  • Objective: To investigate the optimal timing of radiotherapy with alternating/sequential radio-chemotherapy for limited-stage small cell lung cancer (LS-SCLC). Methods: 91 patients with LS-SCLC were retrospectively analyzed and divided into two groups according to the number of chemotherapy cycles before radiotherapy. If the patient received radiotherapy after 3 cycles or fewer cycles of chemotherapy, classification was into the early group, if not, into the late group. All patients received 6 cycles of standard chemotherapy (EP/EC) and conventional radiotherapy (56 gy~ 60 gy/28 f ~30 f). Results: The response rate (RR) of the early and late groups were 85.7% and 81.6%, respectively, with no significant difference (p>0.05). In contrast, the progression-free survival (PFS) in the early group was better than that in the late group (11.8 months vs 9.86 months), and the difference was significant (p<0.05). There was no significant difference between two groups in adverse reactions, which gastrointestinal irritation and bone marrow suppression being the most common (p>0.05). Conclusions: Radiotherapy after 3 cycles or fewer cycles of chemotherapy does not bring significant benefits for RR of patients with LS-SCLC, but it could significantly prolong their PFS without increase in adverse reactions.

Experimental study on the effect of low energy laser irradiation in Langerhans cell of Lanaged rat oral mucosa (저출력 레이저 조사 백서구강점막 창상부 Langerhans 세포에 미치는 영향에 관한 실험적 연구)

  • Cho, Jae-O;Hanks, Carl T.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.217-228
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    • 1993
  • The purpose or this study was to observe the histological alteration of Langerhans cells on wound healing process in applying low energy laser irradiation. For this study, 50 Spraque-Dewly rats, weighing 150Gm or more were devided into control, experimental control group(0), 47.5Hz(1), 190Hz(3), 380Hz(5), 760Hz(7), lased group. All the experimental animals were made excision wound on buccal mucosa, 2mm depth, and lased with stoma laser (904nm, semconductor type ASGaAI, Sedalac France) 47.5Hz, 380Hz, 960Hz, 3minutes one time respectively except experimental control group. After the experiment, experimental animals were sacrificed after 24hours, 48hours, 72hours on each. Taken specimens were embedden in paraffin, sectioned 6-8u in thickness. And the langerhans cell were detected using ant S-100 protein antibody, and histochemically processed with Avidin Biotin complex method. All the Langerhan cells were calculated under light microspe in 400 multiplication field and standard deviation, probability test between each group were evaluated using statistical analysis system(S.A.S)program. Following results were obtained. 1. Langerhan cells were increased in experimental control group compared to that in control group(P<0.01). 2. 24hour after experiments, Langerhans cell were decreased compare to that in control group and control experimental group 5, 1, 3. Probability test shows significance between control experimental and 5, 1, 3 group on a =0.05 range. 3. 48our after experiment, Langerhans cells were decreased compare to that on experimental control group, and probability test shows significance between control experimental and 3, 7, 5 group an a=0.05 range. 4. 72hour after experiments, Langerhans cells were decreased compare to that on experimental control group and probability test on group comparison shows significance between control experimental and 1, 5 and 1 between 3, 7 between 3, and 5, between 7, respeilively on a=0.05 range. 5. Langerhans cells number in experimental group were decreased compare to that on experimental control group in applying laser irradiation.

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Mixer using the direct-conversion method (직접 변환 방식을 이용한 주파수 혼합기)

  • Lim Chae-sung;Kim Sung-woo;Choi Hyek-Hwan;Lee Myoung-kyo;Kwon Tae-ha
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.9 no.6
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    • pp.1269-1276
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    • 2005
  • In this paper, Mixer using the direct-conversion method intended to use in front-end of a RF receiver is designed. The direct conversion Mixer is an alternative wireless receiver architecture to the well-established superheterodyne, particularly for high integration, low power, and low cost. It operates at 2.4GHz band, and is designed and simulated with a 0.35um CMOS technology and HSPICE simulator. Layout is implemented with a Mentor IC Station. The 2.4GHz CMOS Mixer employs a modified single-balanced Gilbert Cell with additional MOSFET in the output stages to improve IIP2, which is a standard of linearity in direct conversion receiver. Additional coversion-stages's transconductances are controlled by each MOSFET's physical properties. The HSPICE simulation results show that the 2.4GHz CMOS Mixer has voltage gam of 29dB, IIP2 of 63dBm, respectively. The Mixer also draws 3.5mA from a 3.3V supply.

The value of prophylactic cranial irradiation in limited-stage small cell lung cancer: should it always be recommended?

  • Koh, Minji;Song, Si Yeol;Jo, Ji Hwan;Park, Geumju;Park, Jae Won;Kim, Su Ssan;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.156-165
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    • 2019
  • Purpose: Prophylactic cranial irradiation (PCI) is a standard treatment for limited-stage small cell lung cancer (LS-SCLC) showing a response to initial treatment, but many patients do not receive PCI due to comorbidities or refusal. This study aims to define the patient group for whom PCI can be omitted with minimal risk. Materials and Methods: Patients with LS-SCLC who underwent radiotherapy with curative aim at our institution between January 2004 and December 2015 were retrospectively reviewed. Patients who did not receive PCI were evaluated for brain metastasis-free survival (BMFS), progression-free survival (PFS), overall survival (OS), and prognostic factors for survival, and treatment outcomes were compared with a patient cohort who received PCI. Results: A total of 350 patients achieved a response following thoracic radiotherapy, and 190 of these patients did not receive PCI. Stage I-II and a complete response (CR) to initial therapy were good prognostic factors for BMFS and OS on univariate analysis. Patients with both stage I-II and a CR who declined PCI showed comparable 2-year BMFS to those who received PCI (92% vs. 89%). In patients who achieved CR, PCI did not significantly improve OS or PFS. Conclusion: There should be less concern about omitting PCI in patients with comorbidities if they have stage I-II or a CR, with brain metastasis control being comparable to those patients who receive PCI.